Tuberc Respir Dis > Volume 86(1); 2023 > Article
Smith: Captive
“Captive” (Figure 1) is a digital art piece that I created in Affinity Designer and the artificial intelligence software Midjourney ( It depicts a person imprisoned between a pair of colossal lungs. It is inspired by a patient I met who had chronic obstructive pulmonary disease. He was a former smoker with a 30-pack-year history, and his face fell whenever he talked about smoking. He described a deep shame and shared that he sometimes felt he was “just getting what (he) deserves.”
During my last visit with this patient, he told me there was something he wished his healthcare team had been able to understand: a constant sense of feeling imprisoned and betrayed by his lungs. With tears in his eyes, he cataloged the innumerable ways his life had changed post-diagnosis. He said that at times being in the doctor’s office or the hospital felt like a desperate chance to convey the sheer magnitude of how upended he felt—a short few minutes to share years of experiences.
This piece is a reflection on this patient’s experience. The lungs towering over the figure represent the immensity of life changes a respiratory diagnosis can induce. The figure stands in front of a metal grate, meant to evoke the tension between needing one’s lungs and feeling betrayed by them. The piece is intended to be a visualization and reminder of how our patients may consider respiratory diseases—not as puzzles out of a textbook, to be seen, treated, and discharged, but rather as frightening potential tectonic shifts in the course of their lives.


Conflicts of Interest

No potential conflict of interest relevant to this article was reported.


No funding to declare.

Fig. 1.
Digital art of a person trapped between two colossal lungs. Created in Affinity Designer and Midjourney (
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Brian Robert Smith

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